In September 2025, Dr. Jackie Kohon of Portland State’s Institute on Aging led a group of 11 Portland State students from across disciplines to learn about the complexities of Japan’s “super-aging” society. While many countries will experience an increase in their older adult population over the coming decades, Japan is home to the highest proportion of older adults in the world. Because of this, Japan is at the forefront of addressing the challenges as well as embracing opportunities created by changing demographics.
Quick facts on Japan’s aging population
- Nearly thirty percent of Japan’s population is 65 and older, and is expected to reach 40% by 2060 (Arai et al., 2015), compared to approximately 22% in the U.S (Administration for Community Living, 2024).
- Japan’s average life expectancy is 84.5 - one of the world’s highest life expectancies - compared to 78.4 in the US (Rakshit et al., 2024).
- As of 2025, 1 in 5 people over the age of 65 in Japan are living with dementia, with an expected increase to 1 in 3 people by 2060 (Ishihara et al., 2023).
- In addition to Japan’s system of universal healthcare, in 2000, the country also instituted compulsory long-term care insurance (LTCI) to support the care needs of this growing older adult citizenry.
A Recap of "Japan's Super Aging Society" Program
Day 1: Kashiwa Community Visit
Students started their immersive learning by visiting an affordable housing community nestled 25 minutes by train outside of central Tokyo, called Toyoshiki. Toyoshiki opened in 1964, and mostly housed young couples looking to live in the suburbs. Sixty years later, this community’s demographics have aged considerably, and so have the services designed to support them. Students heard from researchers working to adapt the community’s infrastructure - Dr. Jun Goto of Tokai University and Dr. Mai Takase of the University of Tokyo - and had a chance to tour the grounds, shop in the local supermarket, and observe a lively karaoke class in the senior center, led by a retired professional singer.
Dr. Jun Goto of Tokai University and Dr. Mai Takase of the University of Tokyo started our morning by presenting on their research.
Students on a walking tour of the Kashiwa Community led by Dr. Mai Takase (pictured in the white top) and Dr. Jun Goto.
We had the privilege of sitting in on a karaoke class at the local senior center and enjoying a performance.
Day 2: Ryusen Nursing Home & Creative Aging Project
Students toured a 140-person skilled nursing facility within Tokyo’s Taito ward that opened in March 2025. This is a publicly funded state-of-the-art facility for high needs and dementia care, and students learned about the technology used throughout the building, including bed monitors that help staff optimize sleep and safety for residents, robotic seals that interact with older adults through song and dance, and even a bathtub with a built-in chair lift. Students engaged in a Q&A discussion with leadership, occupational therapists, nutritionists, social workers, and specialized dementia care providers.
Students meet the robotic seals in the lobby of Ryusen. The robotic seals can recognize up to 100 different faces through cameras in their eyes. They dance, wave, and are warm to the touch.
Bed sensors help care professionals monitor residents' sleep quality and restfulness, among other things.
We also visited the Tokyo Metropolitan Art Museum to learn about a program called “Creative Aging Zuttobi,” which brings together people living with dementia, their caregivers, healthcare professionals, and volunteer “art interpreters” to appreciate selected pieces of art in the museum. This was a fascinating example of a “cultural prescription,” where, similar to a pharmaceutical prescription, a doctor prescribes engaging in a cultural event with the goal of reducing social isolation and feeling a sense of belonging.
Students reflect on the importance of appreciating art as a way to live in the moment and connect to culture.
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We explored a few art exhibits in the museum, including one on "DIY."
Imagine a multi-floor, cutting-edge hospital with dozens of specialties, research labs, and community rooms all designed around the needs of older adults. From the moment we stepped onto campus, it was clear that older adults were the priority at the Institute, down to the clear signage, accessibility while moving around the building, incorporation of nature, and so much more! We met with Dr. Hiroshi Murayama, a researcher, to learn about the Institute's work to encourage social participation among older adults and create a new care assistant position to address the caregiver worker shortage in Japan.
From the Institute in Tokyo, we boarded a Shinkansen - a bullet train that reaches speeds up to 200mph - to make our 3-hour journey to Akita City in the north of Japan. Akita is the oldest and most quickly depopulating prefecture in Japan. We started the rural half of our trip by having dinner with Nobufumi Takeuchi, an Akita Prefectural Council member, where we discussed aging demographics and priorities related to aging society, local politics, urban planning initiatives, and the importance of meeting your constituents where they are.
Nobufumi Takeuchi shares his perspective on aging demographics in Akita.
Two special guests - Namahage who are demon-like beings that look for people acting lazy or naughty - made a special appearance at our dinner. Luckily we passed their tests!
Oga is a small traditional fishing village in Akita that is quickly depopulating, and the students felt this reality through the quiet streets, the abandoned homes, and the lack of children. We were hosted in one of the town’s local temples, Dairyuji, by head priest Keno Miura and his wife, Gretchen. Students learned about important cultural traditions practiced in rural Oga, including monthly home visits that Keno makes to residents, viewed a room where family members keep their ashes and memorials inside the temple, and had a discussion around practicing grief and spirituality in Zen Buddhism through the lens of Japanese culture.
The peaceful grounds at Dairyuji, where the only sounds were cicadas and wind chimes.
Keno and Gretchen share the history and traditional role of the temple in Oga.
For dinner, we were treated to a cooking class led by Yukiko Kudo, and made several local dishes including grilled fish, tempura vegetables, and hand-pounded rice balls in a delicious soup.
Everyone had a hand in preparing our traditional dinner, guided by Yukiko Kudo.
Day 5: Community Center & Akita City Urban Planning Tour
The next morning, Keno led students in a zazen meditation, which helped us practice staying in the present moment even within a whirlwind of travel. We ended our time in the Dairyuji temple by helping with traditional chores: opening the windows, mopping the floors, and folding up our tatami mattresses.
A glimpse of the zazen meditation in action.
Students traveled back to Akita City, where we met with Mrs. Mio Kimura and Mrs. Yoriko Saito - two very active older adults - to learn about community activities, support, and chonaikai (neighborhood associations). Chonaikai play an important role in community life; one of their primary functions is to strengthen social and cultural ties through participation in traditional festivals and ceremonies, increasing social connection and keeping traditions alive across generations.
In the heart of Akita City, we took a walking tour with Kazu Saito, an urban planner who played a key role in developing the Akita City Cultural Creation Center, a stunningly innovative use of previously abandoned space that encourages people to come together across generations for arts, crafts, coffee, and other ways to build community. The Cultural Creation Center is an example of a publicly funded initiative that works to keep the city vibrant and connected despite the challenges of a rapidly aging and depopulating community in a rural setting.
Kazu Saito discusses his work around connecting people in Akita to culture, community, and art.
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One of many "do something silly" photos!
A boardwalk that floats on top of a lotus garden in central Akita City.
We spent this night in a rural ryokan, a traditional Japanese inn. Students had the opportunity to soak in an onsen, a natural hot spring bath, and sleep on tatami mats.
A traditional dinner served in the midst of evening onsen soaks.
Like Oga, Gojome is another small village in Akita prefecture, and is also facing a rapidly aging demographic. We learned that 15% of the homes in Gojome are abandoned - often left by people who have passed away, without enough younger people to occupy them. There used to be 8 elementary schools in Gojome, and now there is only one. At the same time, Gojome has an incredibly rich history of holding an outdoor market several times a month for the past 500 years, where vendors sell various goods, such as local vegetables, seafood, handmade crafts, plants, and street food. Because of strains created by aging and depopulation in Gojome, it has been challenging to keep the market running year after year. Even still, the community has gone through great lengths to keep the tradition going as it plays a significant role in local culture and tradition.
Local news documents the market vendors.
Free samples to be shared!
Students helped the owner of a local diner that serves meals to older adults by packaging their pickled vegetables to sell at the market, and enjoyed a rainy morning exploring the market and the surrounding neighborhood. We were also treated to a hot lunch at the diner, which is an important “third place” for older adults to gather outside of their homes. Many students agreed that this was the most enjoyable meal of the whole trip!
Day 7: In-Home Care Presentation
On our last day, in addition to working on student presentations, we learned about the landscape of in-home care for older adults from Masumi Enoki-san, who owns and operates a caregiving business. We learned that while 90% of older Japanese adults want to die at home, only ~10% actually do. In-home care is an important part of keeping people safely and comfortably at home for as long as possible; however, there is a huge worker shortage to meet the demand. Masumi Enoki-san shared a comprehensive comparison of healthcare services and structures between Japan and the US, and inspired us by her commitment to paying her workers more than industry averages, hiring by referrals only, and minimizing paperwork – all in all, creating a successful business that provides quality care for older adults living at home.
Masumi Enoki-san with the group after learning about the landscape of in-home care.
Most of our group ended our last night together at the bar owned by our dear friend and travel guide, Yuki. Yuki played an important role throughout our trip, helping us smoothly navigate across Japan while putting a smile on our faces!
Student Research Topics
Throughout the program, students worked in pairs and trios to conduct qualitative research on a variety of topics around aging in Japan, including:
- Nutrition - the influence of the traditional Japanese diet and innovations for supporting the nutritional needs of older adults
- Support for people living with disabilities
- Impact of policies on community integration of people living with dementia
- Grief support and social isolation
- Age-friendly cities and urban planning
Stay tuned for opportunities to learn more about student research!
References
Administration for Community Living. (2024). 2023 Profile of older Americans. In Administration for Community Living. https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf
Arai, H., Ouchi, Y., Toba, K., Endo, T., Shimokado, K., Tsubota, K., Matsuo, S., Mori, H., Yumura, W., Yokode, M., Rakugi, H., & Ohshima, S. (2015). Japan as the front-runner of super-aged societies: Perspectives from medicine and medical care in Japan. Geriatrics & Gerontology International, 15(6), 673–687. https://doi.org/10.1111/ggi.12450
Ishihara, M., Matsunaga, S., Islam, R., Shibata, O., & Chung, U. (2023). A policy overview of Japan’s progress on dementia care in a superaged society and future challenges. Global Health & Medicine, 6(1). https://doi.org/10.35772/ghm.2023.01047
Rakshit, S., McGough, M., & Amin, K. (2024, January 30). How does U.S. life expectancy compare to other countries? Peterson-KFF Health System Tracker. https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/#Life%20expectancy%20and%20per%20capita%20healthcare%20spending%20(PPP%20adjusted)